What is ‘valvular’ atrial fibrillation? A reappraisal

Abstract

Despite the same electrophysiological abnormality, the risk of stroke and systemic embolism in atrial fibrillation (AF) ranges from 20%/year and can be assessed by simple clinical risk factors.¹ This has led to the gradual adoption of vitamin K antagonist (VKA) oral anticoagulation as a preventive strategy for most patients with AF, unless clearly identifiable to be at very-low risk.^2,3 The recent availability of non-VKA oral anticoagulants (NOACs) is likely to increase the number of AF patients treated with these drugs for stroke prevention in the future. In some such patients, atrial appendage occlusion devices are now also a viable alternative.³